As my dad lay dying in the bed on the right side of the semi-private room, the pain that I felt in my heart was inexpressible.   You see, for all intents and purposes, my life had been pretty much perfect up to that point, and when the call came from the hospital that “I should come as quickly as possible because my father was most probably not going to be with us much longer,” I could not have driven faster, not have run at a quick enough pace and not felt more pain than those words produced.  It was a given that eventually my dad might die from his disease, lung cancer, but it was never clear to us that his passing at 58 years of age would occur so quickly.

Dad was the son of Italian immigrants who, like many of the people who came to this country in hopes of creating a better life for themselves and their families, ended up living in what was in essence a company owned home where they paid rent to their employer from their minimum wage salaries until my grandfather passed and his widow, my grandmother, was evicted.  It was the immigrant life that had caused my father to be somewhat of a pessimist and yet to embrace every one of our successes as if it was a Super Bowl win.

My dad had not been able to afford college, even with the offer of scholarship assistance, and he had worked his entire life in jobs that sometimes provided barely a middle class income to his family.   His endlessly stated goal for his children was that we get a college education.     He did not care about the field of concentration or what we decided we wanted to be, just that we were officially educated.  Imagine his pride when both my brother and I completed our Master’s Degrees and then continued to seek education beyond that level.  He was a very effective cheerleader and, at the same time, a strong and determined father who provided us with the roots that we needed to move forward and the freedom that was required for us to grow, thrive and survive on our own volition.

But  on July 5, 1975, 7-5-75, he was consuming the last hours of time that he had been allocated on this planet, and my heart was breaking.  As tears streamed down my face, he leaned over, gasping for breath, and said, “Kid, you’ve got to toughen up.”

I’m happy to report that I never have.

The death of my father in a traditional U.S. hospital in 1975 has steered many of my career and personal decisions.  You see, from my perspective, my father’s death was a very real example of how people were and unfortunately are, in many cases, still being treated.   It is what eventually took me into healthcare administration, the Planetree philosophy of care, and, most importantly, the American Board of Integrative Holistic Medicine.   It also allowed me to appreciate the amazing good and healing that takes place in Palliative Care and Hospice as well.

Bottom line, these organizations introduced us to the power of unconditional love.  When Father’s Day comes around, I can still see the smile on my Dad’s face, and then I recreate the unbelievable moment when he whispered to his nurse during one of his very last minutes of consciousness, “What did Dick Tracey do today?”    He embraced humor, honor, dignity and love to the end.   So, too do the physicians of ABIHM and the believers of Planetree.    ABIHM is completely about providing unconditional love to their patients, their families and the people who actually provide the care.

This is all about human dignity.  It is about nurturing, caring and carefully selecting the appropriate words to give hope and support even in times of transition.  This  should be the future of healthcare in this country.

First I would like to reinforce what drives me as a person and consultant along with my purpose and passion.   My training and background is in Education, the Arts, and Healthcare Administration, but I was mentored and guided by people who added intuitive management capabilities to my skill base.  In simple terms, despite what the financial analysis and traditional business people may say, those mentors helped me understand that two plus two can equal 5 or 55; not always from a logical or traditional standpoint but from a creative and passionate one.

In July of 1975 one of my mentors was hospitalized and while I was sitting with him he turned to me and uttered his last words, “What happened to Dick Tracy today?”  He embraced humor to the very end and passed away minutes later at the age of 58.   He was my father, and the experience that our family had in that health care institution made me want to avoid hospitals at all costs forever.  Instead, I later decided that I would not only enter hospitals but would also work to lead them and change the philosophy of how patients are treated.   As a CEO, we offered integrative medicine, aroma, massage, pet, music and humor therapy as well as all other certified modalities in integrative holistic medicine, but most importantly, our patients were never asked to leave their dignity at the door.

From that day forward I dedicated much of what I do to those people who help other people with their own health by using my ability and knowledge from both my creative and innovative education to the more concrete business and reality skills that I’ve developed as a CEO and Founder of a Research Institute.    During the last 25 years I have met incredible people both nationally and internationally and have done my best to share what I believe is a tremendous failing in the health care industry; providing patient centered care with compassion by creating a truly healing environment through entrepreneurship.

My vision is simple.  Strategically help you to reach your goals in an exciting and creative manner.  This is not about a business plan, this is about a deliberate strategic plan centered in Integrative Medicine and the new techologies and with evidence based outcomes, we will demonstrate how you can fit into this ever evolving new world order as the current system continues to shift dramatically.

With innovation, compassion and creativity, the future can most assuredly be incredibly exciting.

When you’ve been around longer than 2/3’s of the folks in the United States, everything begins to look a little skewed.  My new periodontist, for example, makes the neighbor’s  children look almost middle aged, and the fact that I have a periodontist allows me to finally understand the expression, “Long in the tooth.”   This afternoon, the waitress that brought me my sandwich at the Diner seemed to be checking over her shoulder periodically to see if the truant officer was coming to take her back to the eighth grade.   Oh, yeah, and the kid who checked my battery?  Except for the tattoo on his neck and that pierced eyebrow, I thought the only batteries that he would be familiar with might have been removed from his Star Wars light saber.  

Everyone tells me that age is relative and I completely agree with that, but this isn’t really about age; it’s about wisdom and experience.  Don’t get me wrong.  Plenty of folks get older and never seem to wise up.  In fact, it seems to me that Fish Oil should be built into our cereal, milk and pancakes because lots of people today need to have something to give their brains a boost, any kind of a boost.    It has been my experience , however, that those of us with enough battle scars seem to have had to either gain that knowledge or perish. What’s the expression, we all age, but not all of us grow?

Once, after being verbally attacked by a somewhat unstable man who, unfortunately, was one of my superiors at the time, a great silence fell across the room.  He had yelled and screamed that I should be fired, but it was clear that, had the gun laws been just a little more lenient, his real desire would have been to eliminate me from the human race.  Anyway, after his tirade, an outburst that only Judge Judy could have matched, a lone voice rose from the group of people in the room who had heard his accusations and demands. 

The person who spoke up did so in a very deliberate manner and said the following, “When I was a kid, my father told me that I would be lucky in my life to end up with six friends.  When I met Nick, I felt that friendship instantly, and he has proven to be one of my six.”  (Or something like that?)  Then he said to the ranter, “Maybe you should leave.”  It’s not often that someone has the guts or the heart in a tense moment like that to stand up for a friend in the midst of a dozen or so very powerful people.  As it turned out, he was supported in his request, and my life and job went on, but that moment will never be lost.  (Thanks, Ron.)

Well, today, one of our sixth friends left us.  When I got the E-mail, my heart sank, not just a little, but a lot.  You see, today, the person who passed took a piece of me with him because, like my hero above, he had been a cheerleader, guardian, and supporter from the first minute that we met.  He was one of those special people who, no matter how bad the lightning was flying from the storm overhead, would run out to support and protect you from the elements with his very personal umbrella. 

I’m sure that his family knows how much he was loved, respected and will be missed, and I’m positive that mine does. 

In the words of Kahlil Gibran, “Only when you drink from the river of silence shall you indeed sing . . . And when the earth shall claim your limbs, then shall you truly dance.”  

We will miss you, Jake, and your presence will always be felt among those who loved you. 

Today, I received an article from a friend written by Nicholas Kristof, a New York Times op-ed columnist, titled “New Alarm Bells About Chemicals and Cancer.”  Having lost my father from cigarette smoking related lung cancer (They’ve identified4,000 chemicals in tobacco smoke and at least 69 of those chemicals are known to cause cancer), the headline really didn’t surprise me very much.  After all, we have gone from eating cupcakes made with flour, sugar, baking powder, salt, shortening, milk, vanilla and eggs to eating faux cupcakes made with niacin, iron reduced, thiamine mononitrate, riboflavin, palm oil interesterified, palm kernel oil, partially hydrogenated cottonseed oil partially hydrogenated with TBHQ, emulsifiers, sorbitan monostearate, mono and diglycerides, sodium stearoyl lactylate, propylene glycol monostearate polyglycerol esters of fatty acids, sorbic acid and a little bit of flour, sugar, eggs et al.  You get the point.

Some of the low-lights of the article included facts like, 300 contaminants have been detected in umbilical cord blood of newborn babies which means that these babies were already polluted when they were born!  The other very disturbing detail that came out was a quote from the report which says, “Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety.”  Just think of it.  Only about 79,800 other chemicals MIGHT BE DANGEROUS.  Heck, the food industry is already screaming because there is a bill before the Senate to ban bisphenol-A, commonly found in plastics from food and beverage containers.  Right or wrong, BPA has been on the endangered drug list for years.

Okay, unless you make your living from treating these folks, here’s the really bad news.  About 41 percent of Americans will be diagnosed with cancer at some point in their lives, both Republicans and Democrats.  So, the issue shouldn’t be a political issue, but, because it is also an economic issue it is not being addressed equally.

As a healthcare professional, it is tough to see the new statistics involving the cancers that are becoming more and more common with children.  Could these cancers be happening because of chemicals in our food, water, air and   household products, or is it just Mother Nature trying like heck to keep the seven billion of us from destroying her planet?  You know kind of a guaranteed thinning of the herd?

The good news about the report was that it was filled with suggestions for us common folks relative to self-preservation from these chemicals.  For example, filter your drinking water.  That would seem simple enough, especially if you didn’t store it in heated plastic containers after filtration.  Then there were suggestions like remove your shoes when you enter your house.  Truthfully, I grew up in a house that was not unlike any respectable Japanese home, EVERYONE was expected to leave their shoes at the door upon entry.  I always hated that.  (Primarily because my socks were darned or had holes in them, but it was the law.)

They suggested storing your water in stainless steel instead of plastic and to microwave in ceramic or glass containers.  They also embraced organic foods and suggested that you not eat meats that are too well done.  (They must have seen me bar-b-que.) Oh, and finally they said, “Check radon levels in your home.”  They probably should have gone on to say, and do something about them, too.

Well, today, I met an 89 year old man who had been on the ground in Hiroshima seven days after the bomb was dropped, and he told me that his secret to longevity was never to think about any of this stuff, to hang out with young people, and to drink a lot of high quality alcohol.  He was particularly fond of moonshine?  We all have to die from something.  I guess CEO’s of  the manufacturing companies who use known carcinogens figure they just wanna die rich!

When Clayton Osbon, the pilot of that Jet Blue plane lost it a few weeks ago, the entire world stepped back and asked what was wrong?  Did the weight loss shakes that he sold somehow impact his neurons?  Was he so sleep deprived that he became in-congruent?  What made him snap?  Everyone described him as a rock solid, non-controversial human being, and all of his neighbors, friends and family were shocked by his actions.  

Interestingly, while listening to a talking head about the soldier, Staff Sergeant Robert Bales, who was accused of killing 17 Afghan citizens, the commentator indicated that, sleep deprivation and stress can turn any human being into a moral moron. “Your decisions become so clouded and incongruent that anything becomes possible,” he said.

As a hospital CEO, one of my saddest physician practice memories occurred when one of our top docs began speaking in incomprehensible sentences and acting erratically.   The result was an agreed upon early retirement after which he came back to his full, normal functional capacity.  In a casual conversation with him months later, he believed that he had embraced a personal diagnosis.  You see, he had been working, taking calls, and visiting patients late into the night and was back on the floors by 5 AM every morning.  He attributed his incoherent activities to his sleep deprivation.

Now to a very disconcerting Pittsburgh meltdown; last week a highly respected, top CEO in this area cracked and was arrested for fighting with the husband of his mistress.  His listed salary was about $4,000,000, but more importantly, he was working to lead his organization in a new direction that could literally be a prime example of what may be possible in the new health care arena of these United States. 

Dr. Ken Melani was leading the way in the creation of an Accountable Care Organization that would cover all aspects of healthcare from cradle to grave.  His path was truly one of great risk, amazing strength, and deep understanding of the new Healthcare Reform legislation. It meant taking on the UPMC juggernaut while preserving choice in healthcare in the Pittsburgh region.  It also meant managing numerous very strong personalities who either agreed, disagreed, or thought they could do whatever was to be done in a better way than their leader. 

 Literally at stake were millions and millions of dollars and a $1.2B debt was also knocked into the risk portfolio because of Dr. Melani’s meltdown.   More importantly, however, in this “Battle of the Titans” was the two million or so patients who would be blocked out of the competitions health system when Highmark stood its ground. 

Many countries regulate the work week by law, such as stipulating minimum daily rest periods, annual holidays and a maximum number of working hours per week.  During a conversation with the wife of the Finance Minister in the Netherlands, I told her I would see her in August to which she replied, “You really don’t understand, do you?   We threw out the Pilgrims and Puritans and you still live by their standards.  We have 54 days off a year, and no one will be here in August.” 

It’s a well known fact that US workers put in the longest hours on the job in industrialized nations, and we are spending the most on our health in the United States with some of the worst outcomes, and we are the ONLY nation that does not provide health coverage for its population. Bottom line, maybe Dr. Melani,   Staff Sgt Bales  and Capt Clayton Osborn all needed a break.   Battle fatigue can be a dangerous enemy, and the results can be both economically and physically lethal.  We can’t turn back the clock for any of these individuals, but we can learn to carve out 20 or 40 minutes a day to nurture ourselves, to breathe deeply and to rid our minds of the unnecessary.   Change or DIE. 

In a New York Times Op-ED by Theresa Brown on March 15^th entitled Hospitals Aren’t Hotels, she clearly articulated the company line regarding the new patient centered care requirements being imposed upon hospitals by previously the Bush and now the Obama administrations through CMS.   Although Ms. Brown is most probably a world class nurse, she echoes the sentiment being expressed by many healthcare leaders regarding the realities of current thinking in hospital care.  In her op-ed, she writes that “A lot of what we do in medicine, and especially in modern hospital care, adheres to this formulation.  We hurt people because it is the only way we know to make them better.” 

Having been in senior management in healthcare for over twenty years as an officer and for the last dozen years prior to my retirement as a CEO, this type of rationalizing was a constant symphony.   My experience was very different because it was from the patient’s point of view.   Almost ironically, prior to entering the healthcare field, I was the CEO of a Convention and Visitors Bureau, and I saw firsthand what could be done in healthcare.   The irony for me was that, once I was in a position to introduce a more patient centered environment in hospitals, the push back was relentless and unending.  That was until I became a CEO and took an unmovable stand on this issue.

You see, this is not a situation where patient centered care resulting in higher acceptance wouldn’t work; it is a situation as so aptly described by Ms. Brown where “We hurt people because it is the only way we know to make them better.”   Once while observing a young child being treated in the Emergency Room I heard blood curdling screams.  After the treatment was complete, we brought that team of care givers together to discuss what had happened.  During that conversation, we asked if any type of topical pain killer could have been used.  Their response was, “Yes, of course, we just never did it that way.”  It was done that way from that day forward.

What we are missing here can best be described by reading the poem “Calf Paths,” by Sam Walter Foss in which he describes a walk taken by a medieval calf that ended up being the foundation laid for what later became a road, then a primary street through a medieval town and finally a major highway.  Healthcare is based on conservative tradition, and it is well known that, as stated by a seasoned VA nurse at a presentation that I gave, “We are famous for eating our young if they don’t follow the traditional path set out for them by our healthcare ancestors.”

Our hospital offered massage, stress management, music, aroma, pet and all other types of therapy.  We had 24 hour visiting, beds for our visitors beside their loved ones and double beds in the OB suites.  We baked bread in the hallways, had popcorn machines and live music in the lobbies, but most importantly, we provided our employees classes in emotional intelligence and sensitivity.   We provided them with the knowledge that every aspect of what we did we did as a Good Samaritan.  We embraced the philosophy of “Doing unto others what we would have others do unto us,” and then we capped that with a commitment to provide unconditional love to our patients and their families.

The result?  This hospital had the lowest restraint, readmission, lengths of stay and infection rates of it 18 peer hospitals.  But most importantly, even though the patients came from the same pool of humanity, we had the lowest mortality rates. But here’s the real irony for this lesson, our employee and patient satisfaction rates were in the highest possible percentages.  Treat people with kindness, love and respect.  Explain to them when they will hurt and why and then respect their needs.  That’s not a hotel.  It is a center for healing.